Rectus Femoris to Gracilis Transfer with Fractional Lengthening of the Vasti Muscles: Surgical Technique

1 Department of Orthopaedic Surgery, University of Pennsylvania, Philadelphia, PA Stiff knee gait is often seen in patients with upper motor neuron injury. It describes a gait pattern with relative loss of sagittal knee motion. This aberrant gait interferes with foot clearance during swing, often leading to inefficient compensatory mechanisms and ambulatory dysfunction. At our institution, we have been performing distal rectus femoris transfers and fractional lengthening of the vasti muscles in adult patients. The purpose of this paper was to describe our unique surgical technique.